Few employers plan to drop coverage but many expect more cost sharing

While few employers are planning to drop health benefits after 2014, many anticipate additional future cost sharing with employees, according to a survey conducted by EBN in partnership with Unum. The survey draws on the responses of 771 HR/benefit decision-makers employed at companies with 10 or more employees.

Overall, 71% of respondents report that it is very likely they'll maintain their plans, despite impending changes under the Patient Protection and Affordable Care Act. Employers will, however, expect employees to pay more toward their benefits, with 30% of employers anticipating additional future cost sharing with employees. The largest employers (at least 2,000 employees) are somewhat more likely than the smallest employer group (10-to-99 employees) to shift employee benefit costs to employees. Specifically, only 28% of the smallest employer firms expect to increase cost-shifting, compared to 43% of the largest employers.

Senior executives, meanwhile, are gaining influence in benefits purchasing decisions. While top executives, including chief financial officers, have traditionally played a vital role in benefit decisions at smaller organizations, they appear to be getting more active within larger firms as well. For example, 10% of survey respondents from organizations with at least 2,000 employees report that the role of senior executives in the benefit decision-making process "increased substantially."

Overall, 80% of survey respondents offer some form of voluntary benefits, with some categories far more prevalent than others. Accidental death and dismemberment insurance, for example, is offered by 79% of those surveyed, while concierge services are offered by only 3% of employers. "The somewhat related finding of increasing employee cost sharing for benefits raises the question of whether 'voluntary' benefits will remain a benefit category distinction," according to the report.

Commitment to wellness

The survey data show the prevalence of wellness programs is highly dependent on organization size. For example, 58% of employers with 10-to-99 employees report having a wellness program, while 90% of employers with at least 2,000 employees report having one.

Satisfaction with wellness programs isn't high, however, with 37% of large employers indicating they were "somewhat satisfied." Despite low satisfaction levels, employers don't appear to be shying away from investing in wellness. Fifty percent of employers with at least 2,000 employees plan to increase those programs somewhat, and another 21% plan a significantly higher investment over the next two years.

Increased reliance on brokers

Perhaps not surprisingly - given the growing regulatory and administrative complexities involved in benefits - 25% of employers report that they've increased their reliance on brokers and consultants over the past two years. Only 4% say their reliance on brokers and consultants has decreased.

Reported increases in the use of brokers and consultants were highest among larger employers. For example, employers in the 500-to-999-employee range and 1,000-to-1,999 employee range increased their use of brokers and consultants by 43% and 44%, respectively, compared to only 24% of employers in the 10-to-99 employee segment.

And it appears brokers and consultants are trying harder to satisfy their employer-clients. Overall satisfaction rates were high - 62% reported being "very satisfied" and another 26% satisfied. A small minority (2%) report being "not at all satisfied" with their brokers and consultants.

But satisfaction levels varied according to employer size and industry. In particular, satisfaction levels decline as organization size rises. Just 45% of employers with at least 2,000 employees were "very satisfied," in contrast to employers in the three smallest size brackets, where at least 60% reported being "very satisfied." "Whether the distinction is due to differences in service quality, or varying service standards and expectations on the part of large and smaller employers, is unclear," according to the report.

Satisfaction with the employee education services delivered by their brokers and consultants was also pretty good, with 76% saying they're either "very satisfied" or "somewhat satisfied" with the education services their broker and/or consultant offers.

Carriers, meanwhile, didn't fare as well, with 66% of employers saying they're either "very satisfied" or "somewhat satisfied" with the employee education services offered by their benefit carriers/providers.

Enrollment services garnered the highest level of satisfaction with brokers and consultants, with 57% of employers "very satisfied" and an additional 25% "somewhat satisfied."

Most survey respondents believe their brokers and consultants are doing a good job of keeping them abreast of the health care regulatory environment, with 51% giving a "very satisfied" rating and another 30% "somewhat satisfied."